Abstract
Introduction: Clinical phenotyping in asthma may provide an effective therapeutic approach in patients with severe disease.
Objective: Assessment of clinical characteristics of severe asthma.
Methods: Retrospective study of the medical records of 3850 patients followed-up in our Asthma Clinic over a 5-year period.
Results: 56 women and 26 men, mean age 53.51±14.24 years, suffering from severe asthma according to the 2014 ERS/ATS criteria were found. Average age onset was 38±8.5 years and mean duration of symptoms 14.97±11.06 years. Family history of asthma and smoking history were reported by 21% and 32% of patients, respectively. Atopy was documented with positive skin tests in 39%, rhinitis in 41%, nasal polyps in 15%, aspirin intolerance in 8.5% and clinical GERD in 3.5% of patients. Average BMI was 30.31±6.47. Most patients presented mild obstructive pattern in pulmonary function tests. Statistically significant differences concerning FEV1 were observed in female (p=0.001), atopic (p=0.025) and late onset asthma patients (p=0.021). Also, a female preponderance (p=0.006) and non-allergic prevalence (p=0.002) were observed. Of note, age of onset was negatively correlated with FEV1 (r= -0.338, p=0.003), while duration in years was negatively correlated with %FEV1, %PEF, %FEF75 and FEV1/FVC (r=-0.265, p=0.020, r=-0.326, p=0.040, r=-0.322, p=0.043 and r=-0.334, p=0.003, respectively). Eventually, despite optimal treatment asthma control was not achieved (ACT ≤19) in 30% of the patients.
Conclusions: The incidence of severe asthma in our cohort was estimated approximately in 2%. Late-onset, non-allergic, obese and female predominant were the most common clinical phenotypes.
- Copyright ©ERS 2015